The economic impact of flexible endoscopy in a large academic surgical department

Background: There has been considerable controversy concerning the value added to a general surgery practice when flexible gastrointestinal endoscopy is incorporated. The purpose of this study was to assess the economic impact of flexible endoscopy performed by general surgeons in a large academic practice. Methods: A retrospective review of gross billing charges for a group practice of I I surgeons over the fiscal year 1999 was performed at the Cleveland Clinic Foundation. The total billing for clinic visits and outpatient and inpatient surgical procedures was compiled, and the percentage attributable to flexible endoscopy was determined. Of the I I surgeons, three had incorporated flexible endoscopy into their practice. Results: The three endosurgeons generated 33% of the total gross billing for the Department of General Surgery. Flexible endoscopy alone accounted for 12.2% of the total percentage of gross billings for the department. Meanwhile, this revenue was generated from only 8% of the workweek, when performing flexible endoscopic procedures were performed. Conclusion: Flexible endoscopy can contribute significantly to the financial productivity of the general surgeon.